Chronic lymphocytic leukemia/small lymphocytic lymphoma associated with IgM paraprotein A clinicopathologic study of 26 cases

• Published in: American journal of clinical pathology Vol. 123; no. 4; pp. 594 - 602
• Main Authors: CAMERON YIN, C, PEI LIN, CARNEY, Dennis A, HANDY, Beverly C, RASSIDAKIS, George Z, ADMIRAND, Joan H, KEATING, Michael J, MEDEIROS, L. Jeffrey
• Format: Journal Article
• Language: English
• Published: Chicago, IL American Society of Clinical Pathologists 01-04-2005
• Subjects: Biological and medical sciences; Hematologic and hematopoietic diseases; Investigative techniques, diagnostic techniques (general aspects); Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Medical sciences; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Serum IgM; Plasmacytoid lymphocytes; Clinical form; Malignant hemopathy; Chronic lymphocytic leukemia/small lymphocytic lymphoma; Lymphocytic lymphoma; IgM; Case study; ZAP-70; Anatomic pathology; Chronic; Chronic lymphocytic leukemia; Association; Histopathology; Lymphoproliferative syndrome; Serum; Lymphocyte; Monoclonal immunoglobulin
• ISSN: 0002-9173; 1943-7722
• DOI: 10.1309/FDGWB5C2MYRYXH2E

We studied the clinicopathologic, immunophenotypic, and cytogenetic features of 26 patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) associated with serum IgM paraprotein. The study group (16 men; 10 women; median age, 64 years; range, 40-82 years) represents approximately 2.5% of CLL/SLL cases at our institution. The paraprotein level ranged from 1 to 14 g/L (median, 4 g/L). Neoplasms in bone marrow were composed of small round lymphocytes arranged in nodular (n = 6), diffuse (n = 5), interstitial (n = 5), or mixed (n = 10) patterns. All cases were positive for monotypic surface immunoglobulin light chain, IgM/IgD, CD5, CD19, CD20, and CD23. CD11c (14/20 [70%]), CD79b (11/19 [58%]), FMC-7 (11/26 [42%]), CD22 (8/20 [40%]), and ZAP-70 (6/19 [32%]) were expressed in subsets of cases. Of 17 bone marrow specimens assessed by conventional cytogenetics, 6 were abnormal and 11 were diplold. The overall survival of this group (median follow-up, 24 months) was not significantly different from that for an age-, sex-, and stage-matched group of 52 CLL/SLL patients without IgM paraprotein (P = .60). We conclude that CLL/SLL cases with serum IgM paraprotein are similar to other CLL/SLL cases in their clinicopathologic and immunophenotypic features.